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NICE approves tests for early pre-eclampsia detection

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Pre-eclampsia can be detected with two new tests Pre-eclampsia can be detected with two new tests

NICE has approved two blood tests to help rule out pre-eclampsia in pregnant women.

In the final guidance NICE recommends the Triage PlGF test (Alere) and the Elecsys immunoassay sFlt-1/PlGF ratio (Roche Diagnostics) for women between their 20th and 35th week of pregnancy.

The tests detect changes in the blood that can mean the placenta is not developing properly.

NICE only recommends the use of the tests to help rule-out pre-eclampsia. They have not been recommended to diagnose pre-eclampsia. The guidance calls for further research on the two tests to see if they can be used in future to rule-in pre-eclampsia.

‘At the moment women with suspected pre-eclampsia often have to come into hospital for 24 to 36 hours so we can make a diagnosis, but now, for women between 20th and 35th week of their pregnancy, these new tests may avoid the need for admission to hospital,’ said Dr Jenny Myers, senior lecturer and consultant obstetrician, Maternal and Fetal Health Research Centre, Central Manchester Foundation Trust specialist diagnostics assessment committee member.

‘The tests will be extremely valuable to help rule out pre-eclampsia before the 35th week of pregnancy, when approximately 1/3 of women are diagnosed.’

It is estimated that pre-eclampsia, and associated eclampsia, are the second leading cause of direct maternal deaths in the UK.

Pre-eclampsia is caused when the placenta doesn’t develop properly because of a reduced blood supply. Signs of pre-eclampsia include high blood pressure (hypertension) and the presence of protein in the urine (proteinuria).

It can lead to liver, kidney and lung failure, problems with blood clotting and stroke later in life. It is also thought that women who develop pre-eclampsia during pregnancy may have a greater risk of cardiovascular disease later in life. Hypertension and pre-eclampsia can cause growth problems in the baby, premature birth, or stillbirth. The only cure is to deliver the baby.

Linda Holden and Georgina Longley, midwives at John Radcliffe, Oxford University Hospital, said: ‘Although not every patient presenting with suspected pre-eclampsia will go on to develop the condition, it’s very important to take each case seriously. There is significant unmet need within hypertensive disorders, and this new guidance certainly takes a step towards addressing this. The new test could provide peace of mind for many parents and potentially relieve pressure on the wards and among the antenatal staff.'

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